European Journal of Molecular & Clinical Medicine

Background:The aim of this study is to analyse the role of c- reactive protein and neutrophil lymphocyte ratio accuracy in diagnosis of acute appendicitis and perforated appendicitis.
Materials and Methods: The present study is ROLE OF C-REACTIVE PROTEIN AND NEUTROPHIL LYMPHOCYTE RATIO IN PREDICTING SEVERITY OF ACUTE APPENDICITIS done at Kamineni Institute of Medical Sciences, Narketpally from October 2018 to September 2020.
Results: 100 cases of acute appendicitis which were admitted in kamineni institute of medical sciences were studied. The statistical data and analysis of the cases studied during this period are presented in this study out of 100 cases 14 were managed conservatively and 86 were subjected to surgery, 4 had no inflammatory changes on histopathology and 82 had histopathological features confirming acute appendicitis. Acute appendicitis more common in males than females with a ratio of 2.22:1 with complications also being more common in males. Incidence of acute appendicitis was highest in age group ranging from 20-30 years , with complicated appendicitis being more common in the age distribution of 35.87 +/-18.31 years. Most patients present with pain predominantly in right iliac fossa (100%) followed by nausea/vomiting in 82% and fever in 78% cases. Total leucocyte count was found to be elevated in 86% of individuals with elevations in range of 15825+/-4575 in patients with complicated appendicitis. Neutrophil lymphocyte ratio was found to be elevated in 86% of individuals with elevation in range of 10.6+/-5.49 in patients with complicated appendicitis. CRP values were found to be elevated in 68% of cases. In patients with uncomplicated appendicitis 52% showed elevation of CRP levels whereas in patients with complicated appendicitis 87% showed elevation of CRP levels.
Conclusion: CRP and neutrophil lymphocyte ratio were found to be elevated in cases of acute appendicitis with complications. Elevation in neutrophil lymphocyte ration and c - reactive protein levels can be used to anticipate severity and complications in patients of acute appendicitis.

Background of the Study: Bacterial and Viral infections are often hard to be distinguished in daily clinical practice. Biological markers obtained from a routine examination play an important role to minimize time in providing diagnose and giving therapy. Recently, the use of Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) is greatly considered to differentiate types of infection found in the patients presenting with fever.
Method: This study uses prospective cohort study design and involves patients presenting with fever who are admitted to the ICU. The initial NLR, MLR, and PLR is examined and categorized into types of infection found. The ANOVA test and t-test are performed to find out the difference among study groups with the value of α = 0,05.
Result : This study involves 207 patients (92 male patients [44%]) presenting with fever with the average age of 45,6 ± 14,6 years old. The majority of cases (135 cases [66,5%]) in patients with fever results from bacterial infection; The study also finds 47 cases (34,8%) of typhoid fever and 30 cases (22,2%) of pulmonary tuberculosis. Dengue hemorrhagic fever (DHF) is the most commonly found viral infection with 52 cases (76,4%). The significant diagnose of bacterial infection shows higher value of NLR and MLR than that of viral infection (P < 0,001); Urinary tract infection has the highest value of NLR and MLR, amounting to 9,4 ± 3,6 and 0,23 ± 0,20, respectively. In general, the value of PLR is lower than that of viral infection (P < 0,001).
Conclusion: Neutrophil-lymphocyte ratio, MLR and PLR have benefit to predict diagnosis for the patients presenting with a fever. Bacterial infection is associated with the high value of NLR and MLR, and PLR generally has a lower value in viral infection cases.